While policymakers seek to devise the perfect healthcare roadmap, a select few researchers are focusing on a specific intersection – where health, behavior and chronic disease meet – to determine how best to reduce disease risk and prevent premature death. A new five-year, $11.5 million grant from the National Institutes of Health (NIH) will support an Institutional Development Award (IDeA) Center of Biomedical Research Excellence (COBRE), establishing the Vermont Center on Behavior and Health at the University of Vermont (UVM). The Center, led by UVM faculty members Stephen Higgins, Ph.D., and Philip Ades, M.D., is one of only three in the nation addressing the important challenge of behavioral health from a behavioral economics perspective.

The COBRE grant application was supported by the Neuroscience, Behavior and Health Initiative (NBHI), directed by Rae Nishi, Ph.D., professor of neurological sciences. The new Vermont Center on Behavior and Health will serve as a foundation for the work of the NBHI.

“Unhealthy personal behaviors – substance abuse, physical inactivity, obesity – account for 40 percent of premature deaths in the U.S. annually and substantially increase healthcare costs and health disparities by being overrepresented among economically disadvantaged populations,” says Higgins, UVM professor and vice chair of psychiatry and director of the Center for Substance Abuse Research & Treatment. “It is our goal to better understand the causes and devise more effective prevention and treatment interventions for such unhealthy behaviors,” he adds.

Investigators at the Center will apply the principles of behavioral economics – the consideration of how irrational decision-making impacts the everyday choices we make and can eventually undermine health. The researchers will closely study the impact of socioeconomic factors such as poverty and lower education levels on health-related decision-making as well as the use of incentives and other targeted interventions for promoting healthier choices in vulnerable populations.

Higgins has already made significant headway in this area. An internationally respected expert in contingency management – the use of financial and material incentives to reduce unhealthy behaviors like substance abuse – he’s partnering with UVM faculty and other institutions to identify what interventions will support what he refers to as “healthy behavior change.” His and Ades’ collaborators are Jennifer Tidey, Ph.D., of the Department of Psychiatry and Human Behavior at the Alpert Medical School at Brown University, and Craig Rush, Ph.D., of the Department of Behavioral Science at the University of Kentucky School of Medicine. In addition, UVM internal advisors to the Center include Polly Parsons, M.D., professor and chair of medicine; Charles Irvin, Ph.D., professor of medicine and director of the Vermont Lung Center; Mark Bouton, Ph.D., professor of psychology; Patricia Prelock, Ph.D., dean of nursing and health sciences; and Rachel Johnson, Ph.D., M.P.H., R.D., professor of nutrition and food sciences and pediatrics. External advisors from outstanding universities throughout the .U.S. will collaborate as well.

According to Ades, the COBRE’s mission also involves promoting high-quality research among its most promising young faculty. Initial research projects will include studies of weight control in breast cancer patients and overweight pregnant women; an intervention to increase cardiac rehabilitation participation in Medicaid patients; a study of heart disease risk in women with breast cancer; and a study of the origins of obesity and heart disease risk in childhood psychiatric syndromes. Junior investigators leading these individual projects include Diann Gaalema, Ph.D., and Robert Althoff, M.D., Ph.D., assistant professors of psychiatry; Kim Dittus, M.D., and Susan Lakoski, M.D., M.S., assistant professors of medicine in hematology/oncology; and Julie Phillips, M.D., assistant professor of obstetrics, gynecology and reproductive sciences.

Serving as senior faculty mentors for these younger investigators are Jean Harvey Berino, Ph.D., R.D., professor and chair of nutrition and food sciences; James Hudziak, M.D., professor of psychiatry; and Ira Bernstein, M.D., professor and chair of obstetrics, gynecology, and reproductive sciences. Stacey Sigmon, Ph.D., associate professor of psychiatry, will oversee a behavioral economics research core to support these investigators and others on the UVM campus. She and Higgins will oversee a collaboration and dissemination core that will focus on addressing health-related behavior problems with regional, state, national, and international colleagues, with administrative responsibilities managed by Department of Psychiatry staff members Diana Cain and Susan Deslisle.

“Over time, the flexibility of this grant award will allow this team of investigators and collaborators to move on to other behavioral-oriented medical conditions and projects to bolster the breadth and impact of this interdisciplinary research center,” says Higgins.

“This Center brings together an interdisciplinary group of accomplished senior scientists, promising junior investigators, and distinguished advisors and collaborators who will work closely together to establish a center of excellence in an area of clinical research that is vitally important to public health in this country,” says Ades.

Only two other Centers in the country are similarly focused on behavioral economics and health – the University of Pennsylvania School of Medicine and Harvard Medical School—and only UVM is directing its considerable scientific and clinical resources towards reducing health disparities.

The IDeA program builds research capacities in states that historically have had low levels of NIH funding by supporting basic, clinical and translational research; faculty development; and infrastructure improvements. UVM's IDeA award comes from the National Institute of General Medical Sciences of the NIH under grant number P20GM12345.